hypertension

Question 1

What are the causes of secondary hypertension?

Answer 1

Renal (Renal Vasculitis, Renal Artery Stenosis)
Endocrine (Hypercortisolism, Hyperthyroidism, Pheochromocytoma)
Neurological (Increased intracranial pressure)
Aortic (Coarctation, Atherosclerotic rigidity)
Labile (Psychogenic, stress-related)

Question 2

Risk factors of hypertension

Answer 2

Non-Modifiable:
- Age
- Gender
- Race
- Family History
- Genetics

Modifiable:
- Stress
- Obesity
- Smoking
- Lack of physical activity
- High salt intake
- Diabetes
- High alcohol intake

Question 3

Effects of hypertension on KIDNEYS

Answer 3

Nephrosclerosis

Question 4

Effects of hypertension on CNS

Answer 4

• Lacunar Infarcts
• Intracerebral Haemorrhage
• Cerebral Thrombosis
• Hypertension Encephalopathy

Question 5

Effects of hypertension on HEART

Answer 5

• Hypertensive Heart Disease
  LV pressure overload -> LV hypertrophy -> Impaired LV diastolic filling time -> LA dilatation -> LV failure

Question 6

Effects of hypertension on BLOOD VESSELS

Answer 6

1. Atherosclerosis
2. Arteriolosclerosis
   - Hyaline arteriolosclerosis (Benign hypertension) -> hyaline deposition
   - Hyperplastic arteriolosclerosis (Malignant hypertension) -> fibrous deposition -> “onion-skin” concentric laminated thickening
3. Aneurysm: localised abnormal dilation of a blood vessel in the heart
   - abdominal aneurysm
   –> atherosclerosis is a major contributing factor
   –> presents as an abdominal mass
   –> can rupture, embolise, obstruct
   - thoracic aneurysm
   –> hypertension is a major contributing factor
   –> bone pain due to erosion, cardiac aortic valve insufficiency, difficulty swallowing, respiratory difficulties
4. Aortic Dissection: tear in the tunica intima causing blood to enter and separate the tunica intima and tunica media to form blood filled channels
   - occurs in 40-60yo men with hypertension or young men with Marfan’s syndrome
   - caused by chronic hypertension